autism

The marketing of Risperdal and how atypical antipsychotics became a multi-billion-dollar industry – a shockingly eye-opening article!

August 22, 2025 By Trudy Scott 2 Comments

Even though I’m very aware this happens, this shockingly eye-opening article by Lydia Green is the best explanation I’ve heard….

I didn’t set out to shape the field of psychiatry. I was just a copywriter working in pharmaceutical advertising. But over time, I found myself at the center of a campaign that would help transform how mental illness—and its treatment—are understood in the U.S. This is the story of how we marketed one drug, Risperdal, and how that effort helped turn atypical antipsychotics into a multi-billion-dollar industry.

If you’ve ever wondered how this powerful class of drugs ended up being prescribed for everything from adolescent mood swings to agitated nursing home patients, you’re not alone. The rise of atypical antipsychotics was a business and marketing phenomenon—driven in part by a wave of pharmaceutical mergers in the 1990s. First introduced for schizophrenia, atypical antipsychotics were promoted as more effective and safer than older drugs like Haldol or Thorazine.

While journalists and regulators have addressed this issue, I want to share my memories of marketing Risperdal—the first widely prescribed atypical antipsychotic. This is the story of how we promoted Risperdal not just as a medication, but as a revolution in psychiatric care. It’s also the story of how we redefined schizophrenia, rewrote the safety narrative of antipsychotics, and helped drive one of the most successful (and concerning) pharmaceutical launches in history.

It was also my first realization of the immense power marketers have to shape their version of the truth—and how I eventually came to question the very system I helped build.

This is an excerpt from the excellent article recently published on the Mad in America site. We all need to be aware what happened with this medication and is still happening. It’s so wrong and is just heart-breaking to think how individuals and their families were manipulated and impacted. Unfortunately it’s very likely also happening with many other block-buster medications too – like Ozempic (for weight-loss), Evenity (for osteoporosis) and more.

In this blog, I share stories from social workers and psychologists who were working in the field at time, the overprescribing of atypical antipsychotics to children and teens in the mid-1990s and now, and the powerful effects of tryptophan, GABA, other nutrients and diet for anxiety, agitation, rage and sleep issues in autism, dementia and ADHD.

You can read the full article here – Confessions of an Ad Writer: How I Helped Turn Atypical Antipsychotics into a Billion-Dollar Industry.

Be sure to read some of the many comments from individuals and families who bore the brunt of this. It’s heartbreaking.

Stories from individuals who were working in the trenches at the time

I shared this article on Facebook and here is some of the feedback I received from the community. Laura Ann’s response:

Thank you for sharing this article. I can remember when I was fresh out of my grad social work program and was working in child psychiatry at the University of Maryland, our docs were pushing this drug for young children with ADHD and conduct disorder. Unbelievable! These companies and their executives should be criminally prosecuted.

We tend to think of these scandals as something that happened but aren’t currently happening. I think we will be reading similar articles about GLP-1’s.

I appreciate her for sharing what she was seeing as a social worker at the time. This is so sad and so wrong. I agree that these companies should be prosecuted. Instead they pay massive fines which are part of their marketing and just-doing-business budget, and continue as before.

Unfortunately Laura Ann is spot on, as much of this continues with Risperdal and other psychiatric meds and it’s already happening with GLP-1s. I share more on this below.

Elizabeth Mary’s response:

Just reading your post gave me chills and made my stomach turn. I worked with folks with developmental disabilities during this time period, I had for years! I watched as the antipsychotics and various psych meds infiltrated the group homes and joined a team of co-workers to fight it. We lost. It was disgusting. And I had no idea all this was happening in the background

My heart breaks for these individuals and their families. Bravo to her for trying to fight it and I appreciate her for sharing what she saw happening.

And this feedback from someone else in the community:

This drug was pushed on individuals with ASD (autism spectrum disorder)! Probably still is! Very sad!

I am a retired psychologist who worked primarily with individuals with developmental disabilities. I saw it all the time. The “medical model” was used a lot, meaning many saw psychiatrists and/or PCPs (primary care providers) who prescribed these meds. It has a long history.

Overprescribing of atypical antipsychotics and other psychiatric medications to children and teens – then and now

As mentioned above, I’ve been aware for some time that there is overprescribing of psychiatric medications to children and teens. In one of my interviews on an Anxiety Summit, “Psychiatric Medications in Children and Teens” with Dr. Nicole Beurkens, we discuss these results from this 2019 paper, Current Pattern of Psychiatric Comorbidity and Psychotropic Drug Prescription in Child and Adolescent Patients:

Our study indicates that the rate of presentation to child and adolescent psychiatry outpatient clinics is increasing, and rates of diagnosis and initiation of psychiatry drugs are high among the presented children.
The prevalence of ADHD shows an increase in males and females in our country, and psychiatric polypharmacy (multiple medications) has reached significant rates.

Keep in mind that Lydia Green shared her marketing work began in the mid-1990s, about 25 years before the above paper was published.

Unfortunately not much has changed. This 2025 paper from Swedish authors reports that the “number of prescriptions to children aged 5-17 years has increased” and that “most prescribed drugs were risperidone [Risperdal] and aripiprazole.”

This 2025 paper report that in a group of Australian children with intellectual disability, autism spectrum disorder and cerebral palsy, “risperidone was the most prescribed antipsychotic medication” and it was often prescribed off-label.

Similar increases in antipsychotic prescriptions are also reported in children and teens in Israel in 2025. The list of papers goes on and on and there are similar papers for dementia and other conditions.

There are versions of this story about a lot of diseases: osteoporosis is another one

Melissa’s response to the Risperdal article was this: “Makes you wonder about therapies they are pushing today.” It’s creating awareness which is what we need and she is asking a great question. Yes – there are many versions of this story about other medications.

Here is a perfect quote from this 2009 article: How A Bone Disease Grew To Fit The Prescription

There’s a powerful economic incentive for pharmaceutical firms to expand the boundaries of the use of different therapies. So whether you consider treatments for osteoporosis or treatments for depression or treatments for high cholesterol — in all of these settings — pharmaceutical firms stand to benefit if the therapies for these diseases are broadly used, even if they’re used among people who have very mild forms of these diseases.

In this same article, Caleb Alexander, a pharmaco-epidemiologist at the University of Chicago, is writing about the marketing of osteoporosis medications and says “the dynamic is well understood.” But all this applies equally to the marketing of all medications i.e. “There are versions of this story about a lot of diseases.”

Dubious marketing by the makers of Ozempic and Wegovy (GLP-1s for weight loss)

This is happening right now for GLP-1s. There were already reports in 2023 about dubious marketing by Novo Nordisk, the makers of Ozempic and Wegovy:

In Great Britain, the company has paid within three years a total of around 21.7 million pounds (24.7 million euros) to experts and organisations including important opinion leaders who have since touted semaglutide as a “game changer” in obesity in a campaign described as an “orchestrated PR campaign.

Sadly I expect their marketing campaigns to run unchecked and get more and more sophisticated, with unsuspecting consumers being taken advantage of and harmed.

Families are not aware of the powerful effects of tryptophan, GABA, other nutrients and diet

My goal is to try and change this lack of awareness so families and individuals can explore other options when they are faced with decisions about some of these medications.

Instead of using antipsychotics for a family member with dementia or Alzheimer’s who is experiencing agitation, aggression and anxiety, consider tryptophan and melatonin, and GABA:

Instead of using antipsychotics, explore the use of 5-HTP/tryptophan and/or GABA for kids with ADHD:

Instead of antipsychotics and other psychotropic medications in autism, explore tryptophan and GABA:

This is by no means a conclusive approach to addressing these symptoms in dementia/Alzheimer’s, ADHD and autism. We also need to consider and address diet, other nutritional imbalances, infections, gut health, toxins and much more.

Additional resources when you are new to using GABA and tryptophan as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or low serotonin or other neurotransmitter imbalances may be an issue.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support. You can sign up to be notified when the next live launch is happening.

If you need serotonin support, the Serotonin QuickStart Program is a good place to get help. This is also a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Wrapping up and your feedback

I appreciate Lydia for sharing this and enlightening us, and Mad in Arica for inviting her to do the article. And I appreciate community members for sharing and allowing me to share on this blog

Have you or a family member been the victim of the overprescribing of atypical antipsychotics ?

Have you seen this overprescribing of atypical antipsychotics happening in the work you do as a social worker, psychologist, doctor or other health professional?

Are you surprised to learn about similar strategies being used for marketing osteoporosis and GLP-1 medications?

Feel free to share and ask your questions below.

Vitamin B6 and magnesium on neurobehavioral status of autism spectrum disorder with hyperactivity and irritability (research)

May 24, 2024 By Trudy Scott 7 Comments

Today I’m sharing new research that supports some of the original findings about vitamin B6 and magnesium published by autism biomedical pioneer Bernie Rimland.

Despite the small population size, this study demonstrated neurobehavioural improvement among children with ASD [autism spectrum disorder] with hyperactivity and irritability. Consequently, it can be expected that future studies conducted on a larger scale might help to establish the beneficial role of Vitamin B6 and Magnesium as a complementary treatment for autism with hyperactivity and irritability.

The above comes from the conclusion of this 2021 paper, Vitamin B6 and Magnesium on Neurobehavioral Status of Autism Spectrum Disorder: A Randomized, Double-Blind, Placebo Controlled Study.

There were 50 children in the study, with a random assignment of 27 to the study group (vitamin B6 and magnesium) and 23 to the control group (placebo). All the children were autism patients from a pediatric autism and neurodevelopmental disorder outpatient clinic in India.

One of the primary aims over the 3 month study period was to investigate “any improvement among the six domains of ASD: general observation, cognition, emotion, social behavior, communication, and sensory deficits.”

Read on for learning more about the study outcomes, and dosing and forms of magnesium and vitamin B6 (and how this compares to P5P). I also share more about autism biomedical pioneer Bernie Rimland’s earlier research and the autism/B6/pyroluria connections. And end with some of the many possible mechanisms, GABA and vitamin B6, and other applications for vitamin B6.

More about the study outcomes

The improvement observed in the study/intervention group was 81% compared to only 47% in the placebo group.
Both the study group and control group had a mixture of patients rated as having mild, low moderate, high moderate and severe symptoms of ASD. At the conclusion of the study, there were fewer patients in high moderate and severe categories.
There was “an overall improvement in the symptoms of autism along with improvements in specific domains e.g. Emotion and Cognition.” The Emotion domain includes hyperactivity, aggressiveness, emotional lability (or instability) and stress.

Dosing varied by age and forms of magnesium and vitamin B6

The dosage of magnesium and vitamin B6 for the 27 children in the intervention/study group was pre-determined by the age of the subjects: “Patients aged 2-3 years received 50 mg Magnesium and 25mg Vitamin B6 daily, aged 4-8 years received 100 mg Magnesium and 50mg Vitamin B6 daily, and patients aged 9-12 years were given 200 mg Magnesium and 100mg Vitamin B6 daily.”

Patients in both groups received Risperidone for hyperactivity and irritability.

The form of magnesium used in the study was glycinate and the form of vitamin B6 was pyridoxine.

Vitamin B6 and magnesium research by autism biomedical pioneer Bernie Rimland

The authors share that of the many autism studies with nutrients, studies using vitamin B6 and magnesium “given by parents to ASD children have been observed to produce improvement for about 30 years.”

As I mentioned above, this new research builds on some of the original findings about vitamin B6 and magnesium published by autism biomedical pioneer Bernie Rimland. The study authors share this: “Rimland found significant improvement with the use of high doses of pyridoxine, however high doses of pyridoxine showed side effects which could be negated by co-administering magnesium.”

This 1988 paper by B. Rimland is referenced: Controversies in the treatment of autistic children: vitamin and drug therapy, and states that “Among the biomedical treatments, the use of high-dosage vitamin B6 and magnesium received the highest ratings”

Also referenced is this vitamin B6 paper, co-authored by B. Rimland and published 46 years ago: The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study. It states that “Behavior was rated as deteriorating significantly during the B6 withdrawal.”

Vitamin B6, autism and pyroluria

My experience when it comes to vitamin B6 and P5P is primarily with the many individuals in my community who have pyroluria or suspect they do based on their symptoms (here is the pyroluria symptoms questionnaire). This is about 80% of the anxious folks in my community.

I share this because pyroluria is common in autism spectrum disorder:

children with learning disorders and behavioral disorders: 25% (Abram Hoffer)
autism spectrum disorders: 46% (Woody McGinnis)

(more on prevalence and associated conditions here)

And this study found emotional instability – a key aspect of pyroluria and autism – improved with vitamin B6 and magnesium.

For adults with pyroluria, vitamin B6 is used in the range of 100 mg to 500 mg, starting low and increasing as needed. We use dream recall and increased ability to socialize without feeling anxious as a clue that the correct dose is being used.

Keep in mind that 25 mg P5P (pyridoxal-5-phosphate) or the active form of vitamin B6 is approximately equivalent to 100 mg pyridoxine.

I have found that some folks do better on one form of vitamin B6 than the other i.e. not everyone needs P5P and some folks do better with a combination of P5P and pyridoxine. As with all supplements there is no one–size fits all and so the protocol and form of vitamin B6 used in this study group really only serves as a guideline.

The possible mechanisms

The authors mention this as one possible mechanism under these circumstances: “Magnesium inhibits the excitatory channel glutamate N-methyl-D-aspartate (NMDA) and reduces hyperactivity – a part of the emotional domain.” They also mention the fact that “magnesium increases presynaptic releases” enhancing “both short term and long term synaptic facilitation and long-term potentiation, improving learning and other memory functions.”

I’m adding these as possible mechanisms to consider too:

Vitamin B6 is a potent anti inflammatory compound
Vitamin B6 and magnesium are co-factors needed to make serotonin (which is calming and helps with emotional stability) and dopamine (which helps with focus and motivation)
“GABA is formed from glutamate via the addition of glutamate decarboxylase and vitamin B6”
Vitamin B6 offers neuroprotection in situations of excess glutamate release (together with vitamin B12 and B2)
Vitamin B6 is key (together with zinc, evening primrose oil and others) for addressing social anxiety/pyroluria which is common in autism (as mentioned above)
Vitamin B6 and magnesium improve hormonal health
Oxalate issues are common in autism, leading to depleted levels of vitamin B6 and magnesium. Supplementation can help counter some of the adverse effects.

Also vitamin B6 (and other B vitamins) and magnesium are depleted by sugar, stress, dysbiosis, food allergies, certain medications and caffeine. And it’s common to find deficiencies of both.

A comprehensive dietary and functional medicine / biomedical approach, targeted individual amino acids such as GABA and tryptophan, in addition to vitamin B6 and magnesium is imperative in ASD.

Many other applications for vitamin B6

It’s wonderful to be able to share yet another application for vitamin B6, which, in some circles, is receiving an unfavorable reputation about causing toxicity.

Here are a few other related vitamin B6 blog posts that may be of interest:

Because of the role of vitamin B6 when it comes to calming GABA, it’s worth sharing this blog too – Half a crushed GABA Calm for my autistic child: sleep, anxiety and sensorimotor skills (writing, horse riding and swimming) improve. Both vitamin B6 and GABA are commonly beneficial.

And sometimes, vitamin B6 on it’s own provides results – Anxiety and vomit phobia in an 8-year-old: within a week of starting vitamin B6 she made a complete turnaround.

Additional resources when you are new to using amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

There is also an entire chapter on pyroluria and in-depth sections on vitamin B6 and zinc.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

Wrapping up and your feedback

I’d love to hear from you – have you had success with vitamin B6 and magnesium – personally or with your child? How much has helped and which products? (feel free to share the diagnosis and what symptoms have improved)

Have dietary changes and/or addressing pyroluria helped too?

If you’re a practitioner have you seen these nutrients to help in situations like this?

I’m also curious to hear if you’re familiar with the vitamin B6 and magnesium research and work done by Bernie Rimland?

Feel free to share and ask your questions below.

Mom switches her teen son from 5-HTP to tryptophan. In 3 days he has less anxiety, fears and ruminating thoughts, laughs more and sleeps better.

February 16, 2024 By Trudy Scott 40 Comments

My son has autism and OCD. I took him off fluvoxamine in May and used cbd and some other things and he was doing fine up until this past winter. He began having irrational fears and ruminating thoughts/fears that would not stop! I started 5-HTP, theanine, B12, probiotics with him for the last month and did not see any improvement. I was ready to go back to the medication when I came across your blog and information.

I assumed 5-HTP would be better for OCD, but after reading your comments you mentioned that you just switch to tryptophan if the 5-HTP is not working. I had tryptophan at home already. That night I emptied half a capsule into a little stevia flavored water and had him hold it in his mouth for a minute.

He was a different kid after that!!!! This is just the 3rd day but even his teachers are telling me he is doing really well and is less anxious at school. I am so thankful! I am now giving him 500mg in the morning and early evening.

I bought some inositol and plan to try adding that in the afternoons to see if that will help as well. I believe that he has PANDAS. He is a hand washer, and spits a lot, and has lots of other quirks that I would love to see decrease.

I have hope again! I am buying your book so that I can get a good plan going for him. If you have any other suggestions for him please let me know!!

This wonderful feedback was posted in the comments of one of the tryptophan blogs. I’m so thrilled for this mom and young man (he’s almost 20). I thanked her for sharing all this on the blog and offered to share additional generic feedback via a new blog post. I also asked for additional feedback on exactly how the tryptophan helped (more on that below).

Read on to learn how tryptophan helped with his ruminating thoughts, fears, crying and improved his sleep. And my insights about the ideal timing of tryptophan, finding the optimal dose and why it may work when 5-HTP doesn’t. I also share some insights about inositol and OCD (obsessive compulsive disorder).

Low serotonin symptoms and the questions I had about his symptoms

I do hope he continues to see these benefits. Seeing such amazing results in 3 days is always what we’re looking for and it’s not unexpected to get such profound results so quickly!

I had some additional questions so I could share some general feedback as to how I work in situations like this. I wanted to know his age and if the switch to tryptophan helped any of his OCD symptoms and if yes how many notches improvement?

And which of the classic low serotonin symptoms the tryptophan helped and by how much: anxiety? irrational fears? and ruminating thoughts/fears? anything else? (all the low serotonin symptoms here)

Knowing this helps me know if I’m on track with a client i.e. the tryptophan is helping with low serotonin symptoms. And it also helps me decide we should consider increasing the dose and possibly adjust the number of times to use tryptophan. I share more about this below.

Tryptophan helps reduce his ruminating thoughts, fear and anxiety. And he’s laughing more and sleeps better

She shared some specific examples as to how much the tryptophan helps reduce his ruminating thoughts, fear and anxiety. And he’s laughing more and it helps him sleep:

He would often call me or text me throughout the day with questions about his health, and he would come to me 10-15 times in the afternoons/evenings, for about 3 weeks or so, and ask me the same questions about a rare disease that he believed he had.

He would cry and shake with fear and anxiety at some point and I would need to reassure him over and over again that he did not have this disease, and that it was literally impossible for him to have it.

After starting the tryptophan supplements 2x500mg morning/early evening he did not come to me at all and seemed content the 1st day.

Yesterday, he didn’t get the 2nd tryptophan until 5pm so he did come to me with 1 question/concern. I reassured him and he seemed fine especially after his supplement. Then 1 more question later that night but he accepted my reassurance both times and let it go.

So that was a big difference compared to the last 4 weeks. He was also laughing at some cartoon he was watching which I had not seen him do for a month either. Anxiety is less. He is sleeping better too. So far he still seems to believe the irrational things.

Tryptophan is clearly helping so many of his symptoms but we have more opportunities for further gains with tryptophan.

Tryptophan for low serotonin: dosing and timing

As I share in my book and other blog posts, typically 500 mg tryptophan twice a day is a good starting dose, used away from protein mid-afternoon and evening. It’s used like this because serotonin starts to decline in the afternoon. We increase based on individual needs to find the ideal dose. We may also add tryptophan or 5-HTP earlier in the day.

In a situation like this, if we were working together, I’d consider the following:

Adding a mid-afternoon dose of tryptophan
A switch to just afternoon and evening dosing (unless the morning dose was used for a specific reason i.e. morning symptoms)
Adding a second dose of tryptophan each time (he is using Nature Stacks Serotonin Brain Food and I’d recommend Lidtke 500 mg tryptophan for the second dose each time because it contains only tryptophan)

With changes we do one thing at a time and track symptom improvements carefully.

Tryptophan vs 5-HTP?

I commend her for figuring out the switch from 5-HTP to tryptophan.

It’s a well known fact that some folks just do better on one vs the other and if 5-HTP isn’t working I’ll have clients switch to tryptophan and vice versa. I typically start with tryptophan because it seems to be better tolerated. The biggest issue that I see with 5-HTP is that it’s often not tolerated if you have high cortisol. It can also cause nightmares for some folks.

Precaution about serotonin syndrome with tryptophan/5-HTP

There are precautions when using certain amino acids and I always review them with all my clients. If they have been prescribed an SSRI, I have them discuss the use of tryptophan/5-HTP with their prescribing doctor so they can be monitored for serotonin syndrome. With careful monitoring and doctor approval I feel comfortable having my clients use tryptophan/5-HTP 6 hours away from their one and only SSRI.

If they are using more than one SSRI and/or a combination of psychiatric medications, the use of tryptophan/5-HTP is not advised.

None of the above applied in this situation but it’s important to be aware of.

Inositol and OCD: when to consider adding it?

OCD or even mildly obsessive behaviors or thoughts can be a sign of low serotonin. I will do a trial of tryptophan as above and for some folks it’s often enough. Sometimes tryptophan at least helps to some degree and when it’s not enough, adding inositol (a B vitamin) takes it to the next level.

For many folks 500 -1000 mg capsules are typically recommended but this is a really low dose for OCD. The powdered form is really effective because you can increase as needed. You can actually go as high as 18g. I start low, with 1-2g in kids and adults, and keep going up by 2g a week until the obsessive symptoms disappear. More on inositol and OCD here.

GABA, dopamine and endorphin support too

She mentions that her son “seems to be low serotonin, low GABA (1st 1/2 of the list), low endorphins and low catecholamines” so other amino acids are likely to be of benefit too.

As always we used the neurotransmitter symptoms questionnaire and do trials of each amino acid: GABA for low GABA symptoms, DPA for low endorphins and tyrosine for low dopamine. These trials of each one are done one at a time with careful tracking to find the ideal dose before layering in the next amino acid.

Using the amino acids so it’s easy to reduce sugar and go gluten-free

I also asked what dietary changes he has already made and she responded: “We are in the process of reducing sugar and going back to gluten-free as much as possible but this will be hardest to stick to. Have done a keto-like and gluten-free-casein-free diet on and off since he was 4 years old.”

This is a great start and using the amino acids help reduce cravings and make it easy to reduce sugar and go gluten-free.

There is a sugar cravings aspect to all the neurotransmitter imbalances. The type of craving can be found on the above symptoms questionnaire. It’s not uncommon to need support in more than one area:

Low serotonin – tryptophan or 5-HTP for afternoon/evening cravings
Low endorphins – DPA for comfort/reward eating
Low catecholamines – tyrosine for low energy sugar cravings
Low GABA – GABA for stress eating

I’m glad she is getting a copy of my book The Antianxiety Food Solution. It has all the foundational dietary information, sections on cravings and a chapter on the amino acids.

It also has a chapter on pyroluria, which is very common in autism and something I help most of my clients address. Here is the pyroluria questionnaire.

Tryptophan and inositol product options

Products I recommend include Lidtke 500 mg Tryptophan and Designs for Health Inositol Powder. You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).

If you’re not in the US, Doctor’s Best L-Tryptophan 500mg and Now Inositol Powder are products I recommend on iherb (use this link to save 5%).

Additional resources when you are new to using tryptophan and other amino acids as supplements

We use the symptoms questionnaire to figure out if low serotonin or other neurotransmitter imbalances may be an issue for you.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), if you need serotonin support, the Serotonin QuickStart Program is a good place to start. This is a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening. We take a deep dive into product options including Lidtke products and others if you’re not able to access Lidtke.

If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program. This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy program.

Now I’d like to hear from you

Have you had success with tryptophan for anxiety, fears, crying and ruminations? And has it also helped with sleep, how happy you feel and reduced cravings? Has it also helped with OCD?

Did you first trial 5-HTP and then found tryptophan worked better or vice versa?

If yes, what dose and when do you use it?

What about using inositol to further reduce OCD? And what dose helped?

If you’re a practitioner do you use tryptophan and/or inositol with clients/patients with these low serotonin symptoms?

And please let me know if it’s helpful that I’m now including product recommendations and where to get them?

Feel free to share and ask your questions below.

Pathological Demand Avoidance (PDA) in children with autism – how much is behavioral and how much is due to low serotonin?

June 9, 2023 By Trudy Scott 14 Comments

Pathological Demand Avoidance (PDA) is a condition associated with Autism Spectrum Disorder (ASD). It is a rare behavioral phenotype of ASD that is characterized by an overwhelming or obsessional need to resist or avoid demands, which can often lead to sensory overwhelm causing meltdowns and violent outbursts.

Although children in general may often try to avoid demands, children with PDA engage in avoidant behaviors at a greater level.

The key underlying factor is the extreme levels of anxiety associated with a loss of control, which can feel like a panic attack. Because of high levels of anxiety, they will often respond with a “No” even to tasks or activities that they normally enjoy and can spend a great deal of energy trying to gain control of situations and people.

(from an Australian PDA article: What is Pathological Demand Avoidance (PDA) and how can we address it? so I changed the spelling of behavioural and characterised to be American)

This is a typical overview of PDA and the common recommendations (as outlined in the above article) are all behavioral interventions: be an active listener and build trust, depersonalize requests, provide indirect praise, use humor and so on. Many parents find these helpful but the biochemical imbalances that trigger these behaviors are being ignored and/or there is a lack of awareness. I’d like to change this so more children and teens get quick relief.

There may be many different root causes such as low serotonin, low GABA, low blood sugar, gluten sensitivities, low zinc, low vitamin B6, low vitamin D, toxins, infections, phenols, salicylates etc. Today I’m going to discuss low serotonin and my rationale for reaching this conclusion. It’s also one of the quickest root causes to confirm (more on that below).

My rationale for proposing that Pathological Demand Avoidance (PDA) in children with autism is related to low serotonin

If we take the description above, all of these symptoms are classically found when a child (or adult) has low serotonin:

Extreme levels of anxiety
Can feel like a panic attack
Overwhelm
Meltdowns and violent outbursts
Loss of control
Spending a great deal of energy trying to gain control of situations and people (i.e. controlling)
Obsessional need to resist (any kind of obsessing is common when serotonin is low)

The second reason I suspect low serotonin with PDA is the timing of these behaviors i.e. later in the day. The article mentions that “A child with PDA can be very calm, cool and compliant at school and behave much worse at home. This is not because of incompetent parenting but because they have reached their tolerance levels and need to release that suppressed anxiety.”

This may well be a factor, however low serotonin symptoms are recognized as being more severe in the afternoon/evening when serotonin levels start to decline. If these children have low serotonin then it makes sense that these symptoms would start to increase once they get home.

My third reason is that low serotonin is common in autism/autism spectrum disorder (ASD).

Low serotonin is common in autism/autism spectrum disorder (ASD)

This paper, Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism, summarizes it as follows: “The disruption of the serotonergic system is one of the most consistent observations associated with autism. Serotonin in the brain promotes prosocial behavior and correct assessment of emotional social cues.”

Their recommendations are vitamin D and tryptophan supplementation which they say “may be a simple method of increasing brain serotonin without negative side effects.”

Testing for low levels of vitamin D and supplementing accordingly is important.

Are there other low serotonin symptoms and using a trial of tryptophan to confirm

As mentioned above, low serotonin is also one of the quickest root causes to confirm. As always, regardless of the diagnosis, we assess for low serotonin by rating symptoms on a scale of 1 to 10 (with 10 being most severe) and do a trial of tryptophan (chewed or a capsule opened on to the tongue). You will have your answer very quickly because we rate improvements in symptoms in the next 5 to 30 minutes.

In addition to the above symptoms we also look for these: worry-in-your-head and ruminating type of anxiety, phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, insomnia and afternoon/evening cravings for carbs and sugar.

Lidtke is the only brand of tryptophan that I recommend simply because I see it work so well and because of quality issues with tryptophan in the past. Here are the Lidtke tryptophan products I recommend:

Lidtke Chewable Tryptophan 100 mg is a good for doing a trial and works when lower doses are needed as with children.
Lidtke Tryptophan 500 mg can be used for doing a trial. I open the capsule and use 100mg for a child. Going forward this product is helpful when higher doses are needed, especially at night. When opened it doesn’t taste very good but can be mixed with inositol or even glutamine powder or mashed banana.

You can read more on this blog: Tryptophan for the worry-in-your-head and ruminating type of anxiety, see the full list of low serotonin symptoms here and find the tryptophan products on the supplements blog here.

If you’re new to PDA, the DSM and low serotonin/other biochemical factors

Professor Elizabeth Newson was a developmental psychologist known for her work with children in the autism spectrum. This is her 2003 paper on the topic – Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders

It’s not part of the DSM-5, the standard classification of mental disorders used by mental health professionals in the United States. This article, A Brief History of Pathological Demand Avoidance, offers a good backstory and shares why families want it to be part of the DSM.

Whether or not it becomes a distinct condition or autism subtype in the DSM, I’d like to see low serotonin (and likely low vitamin D) being recognized as one root cause. And acknowledging that there may be many other biochemical/nutritional approaches that should also be explored.

These symptoms are listed in the above article, in addition to avoidance behaviors, and all could fall into typical low serotonin symptoms:

verbal and physical aggression when feeling loss of control
self-injurious behavior
property destruction
refusal to participate in self-care such as bathing or brushing teeth (is this depression?)
inability to attend social events (is this fear and social anxiety?)
controlling what noises are allowed in a home, such as no music, or only certain music
inability to allow parents to have friends visit the home (is this also controlling?)
are often combative with siblings
issues with food, what to eat, when to eat, who to eat with
conflict with siblings

As mentioned above we also look into low GABA and low blood sugar (trials of GABA and glutamine will give quick confirmation too), gluten sensitivity, low zinc, low vitamin B6, toxins, infections, phenols, salicylates and so on. Of course, Nutritional and Dietary Intervention for Autism Spectrum Disorder is crucial.

Some success stories and connecting the dots with low serotonin

These two success stories illustrate how successful tryptophan and GABA can be and also how quickly they offer relief:

This blog post illustrates similar low serotonin symptoms and end-of-the-day timing in adults with Alzheimer’s – Sundowning in Alzheimer’s and dementia: melatonin/tryptophan for the agitation, restlessness, anxiety, disturbed sleep and aggression. It’s low serotonin that is the cause, regardless of the diagnosis.

This blog illustrates another mechanism for these types of disruptive behaviors: Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms? There is a serotonin connection when there are phenol issues too.

Resources if you are new to using amino acids as supplements

If you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin and low endorphins).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program.This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy program.

Now I’d like to hear from you

Have you been told your child may have Pathological Demand Avoidance (PDA)? Have you only been offered behavioral change tools and how have they helped?

Has low serotonin (and other biochemistry imbalances) been discussed too?

What symptoms does your child have and are things worse later in the day?

Has tryptophan helped reduce the above low serotonin symptoms in your child? How much helps and how quickly?

Or do you find 5-HTP works better? If yes, how much helps and how quickly?

What other biochemical changes have helped?

If you’re a practitioner, are you hearing about increased discussion of Pathological Demand Avoidance (PDA) and do you address low serotonin with your clients/patients?

Feel free to post your feedback and questions here in the comments.

Somnium Nighttime GABA Cream: insomnia, anxiety, bloated belly, muscle spasms, MS, ARFID, anorexia, Alzheimer’s and autism

May 26, 2023 By Trudy Scott 45 Comments

Somnium Nighttime GABA Cream is a topical GABA product I have been researching and trying personally with success. And folks in my community are reporting good results too. One woman shared this:

Surprisingly this stuff is very strong. I only use a small amount on the inside of my arm and it really helps me sleep better and calm down my nervous system at night. I don’t use it every day, rather I tend to use it when I’ve had a particularly busy or full/stressful day.

I endorse this topical GABA product as something to use in addition to the sublingual, powder, liposomal or opened GABA capsule you may be seeing benefits from OR it may become the one GABA product that works best for your needs – for helping with insomnia, easing physical anxiety and other low GABA symptoms.

I expect it to be beneficial for those with MS (multiple sclerosis), ARFID (Avoidant restrictive food intake disorder), anorexia, Alzheimer’s, autism and special needs children, and if you have severe digestive issues – for anxiety, insomnia and related symptoms.

When to use Somnium and increasing as needed

I do recommend only trialing this GABA cream when you know that GABA does work for you and you are looking for another way to increase GABA levels. I say this because it is more expensive than other GABA products and will only work if GABA is low – so it’s best to be sure.

Also, I have clients use a similar dose when using GABA products interchangeably. Somnium is around 250mg to 500mg for a small pea-size amount (the 1oz jar lasts 45 days, and the 2oz jar lasts 90 days if a pea-sized amount is used nightly.)

When comparing this with the GABA product that is already working for you, don’t forget to compare apples to apples with no confounding influences. So if you still have your period, the time of the month needs to be considered, and diet and other factors like outside stresses of course.

And don’t forget that there is no one size fits all. I have clients increase the amount of GABA when using it as a supplement, in order to find the ideal dose for their unique needs. I use the same logic with the GABA cream – start low and increase as needed.

For nighttime use for improving sleep (and how to use it)

As you’ll see on the website, it’s recommended for nighttime use for improving sleep but I have found there are many more applications (more on these below).

You’ll also see the recommended way to use it is to “Apply a small pea-size amount to skin and massage until absorbed. For best results apply to the back of the ears and the temples before bed time.”

Very quickly after starting to use Somnium myself, I decided I didn’t like using it on the back of my ears and temples, because it’s oily and made my hair greasy.

Rubbing it between my palms and applying some onto my forearms worked as well for my insomnia. Using it on the inner thigh is an option too.

It also helps me with a painful bloated belly and muscle spasms

I’ve also used it for a painful bloated belly at night, rubbed directly on my belly.

And I’ve found it to help back pain/muscle spasms when used directly over the spasming muscle.

(By the way my sublingual GABA product works as well as the GABA cream – I was experimenting with the cream so I could compare the two and offer my feedback.)

An application for specific populations

I also see the application for Somnium GABA cream for specific populations, who may find a cream is a better way to use GABA:

An aging parent with Alzheimer’s disease (and sundowning agitation/anxiety)
A person with ARFID (avoidant-restrictive food intake disorder)
A person with anorexia or other eating disorder
A child or young adult with autism (with anxiety and sensorimotor issues), a child/adult who struggles with taking supplements and other special needs children/adults
Someone with multiple sclerosis (for anxiety and muscle spasms/spasticity)
A person with severe digestive issues and prefers a cream

Low GABA symptoms

As a reminder, if you are new to GABA, it’s an amino acid that helps to address low GABA levels and the associated symptoms: insomnia, physical anxiety, feeling worried or fearful, panic attacks, stiff or tense muscles, feeling stressed and burned-out, craving carbs/alcohol for relaxation and calming, intrusive thoughts, spinning/poor focus, fear of heights, rectal spasms, burning mouth, and visceral pain/belly pain with IBS. See the most current list of low GABA symptoms here.

Is oral GABA not effective?

When I recently shared this GABA cream product someone asked this great question: “Why have I been spending a ton of money on oral GABA if it’s not effective?”

Oral GABA does work and is most effective when it’s used properly i.e. using a capsule opened on to the tongue (and held for at least 2 minutes) or using GABA in powder form on the tongue (and held for at least 2 minutes), or using a sublingual form of GABA. More on all this here – How did you come up with the idea of using GABA on the tongue? (GABA is a calming amino acid supplement used to ease physical anxiety symptoms).

Keep in mind there are many practitioners who are not aware of these methods and will recommend swallowing GABA capsules or tablets. This is not ideal for the majority of clients I have worked with.

There are also some practitioners and consumers who do not believe that any method of oral GABA works (swallowed or using the above approaches) or even that topical GABA works.

The important thing is this: if you do have low GABA symptoms and get symptom relief when you use GABA, you can ignore the naysayers. Better yet, shout it from the rooftops so more people get to learn about the amazing amino acid GABA and get results too!

My recommendation is to first experiment with oral GABA (used as above) and then consider Somnium when you know how GABA benefits you and how much is helping.

A few of the negatives

Here are a few of the negatives: You don’t know exactly how much GABA you’re getting (it’s a proprietary formulation but I suspect it’s 250mg to 500mg for a small pea-size amount); towards the end of the jar it does start to separate a bit/get clumpy; it’s pricey but it does go a long way.

However, it works!

The benefits of combing GABA with chondroitin sulfate

Dr. Christine Schaffner helped formulate the product and shares this about combining GABA with chondroitin sulfate:

Now individually, GABA and Chondroitin Sulfate have their respective health benefits. But when you combine these 2 compounds, something AMAZING happens.

You might’ve heard the phrase, ‘your skin is the antenna of your body’. It’s a fancy way of saying that your skin absorbs everything.

When you combine the 2 compounds… the absorption happens faster than with any other GABA cream on the market. And since chondroitin sulfate is known to pass the blood brain barrier, it’s as if the GABA has hopped on a super-highway straight to your brain.

Here is some feedback from a few of her Somnium customers:

I was waiting to share until I had more than one great night’s sleep after using Somnium Nighttime Gaba Cream. I now have had several nights of deep sleep and the only thing I changed was the sleep cream. It had been years since I slept straight through 7 – 8 hours. I feel SO rested when I get up. Wow!! – Candace

It works! I LOVE gaba and am familiar with how it feels. It’s especially nice to be able to get it in cream form. I’ve been sleeping much more deeply. – Jaya

UPDATE: April 2025 – unfortunately this product has been discontinued. Stay tuned for a new updated formula.

UPDATE: July 2025 – I have been in communication with Dr. Ruggiero’s team at Bravo North America about the new formulation called Bravo cream. He worked with Dr. Christine Schaffner to create Somnium GABA cream. They have shared that “Bravo is the combination of Somnium and Lymphflo; it contains all the active ingredients of the two creams with a delivery system that has been redesigned appropriately to allow the maximum efficacy.”

Purchase Bravo cream with this link – Use trudy15 at checkout to get a 15% discount.

Have you used Somnium in the past and how has it helped you? If you have used it and decide to get the Bravo cream I’d really appreciate your feedback on how it compares.

How does using a GABA cream compare with other GABA products you have used (feel free to share specific brands and how you used them – sublingual, capsule-opened, liposomal or powder). Some folks prefer a cream only and many use a combination of cream and sublingual.

Feel free to post your questions here too.

GABA Calm is a game changer for husband’s sound and tactile hypersensitivity, significant coordination problems and his anxiety

February 10, 2023 By Trudy Scott 20 Comments

My husband is low in GABA and he had significant coordination problems and sensory sensitivity ….. until GABA Calm. 3 tablets per day work great. If he has none, he gets hyper sensitive again and starts tripping over things in the house.

He has always struggled with anxiety and sound / tactile hypersensitivity. Alongside that he often tripped over things. He made great progress when he started using The Listening Program. I wonder if this sound therapy raises GABA and that was why it helped him (although it only partially helped with anxiety)?

When he stopped The Listening Program then his symptoms came back.

He started taking GABA Calm as I saw it in your blogs years ago. Then he found that he didn’t need to do the Listening Program any more.

GABA Calm is a game changer for him.

Denise shared this feedback about her husband’s great results on a blog post about GABA Calm helping with anxiety and sensorimotor skills in an autistic child.

I thanked her for sharing these wonderful results her husband is experiencing. I am inspired to share this feedback as a blog to give others hope. And also because this illustrates the diversity of how GABA can help i.e. it works for adults and children, males and females, and there is different dosing according to each person’s unique needs.

Music therapy: calming effect and GABA mechanisms

This study, Emotional Inhibitory Effect of Music Therapy on Anxiety Neurosis Based on Neural Content Analysis in Hippocampus, reports that music therapy has a calming effect by adjusting the glutamate/GABA balance. This is likely why Denise’s husband found The Listening Program to be helpful in certain ways – glutamate is the main excitatory neurotransmitter and GABA is the main calming neurotransmitter.

GABA, the GABA Calm supplement, hypersensitivity and sensorimotor difficulties (research)

GABA (gamma-aminobutyric acid) is your main inhibitory neurotransmitter and the amino acid GABA can be used as a supplement to raise GABA levels and ease physical anxiety symptoms, help with insomnia, stress eating, intrusive thoughts and stiff/tense muscles.

GABA Calm is one of many different GABA supplements that I recommend to my clients. This particular one is a sublingual/chewable offered as a 125mg dose, which is where I have most of my clients start. Denise’s husband finds that 3 GABA Calm used throughout the day are enough for his needs. These alleviate his anxiety and also stop his sound and tactile hypersensitivity, and significant coordination problems such as tripping.

This paper reports that“Sensory over-responsivity (SOR), extreme sensitivity to or avoidance of sensory stimuli (e.g., scratchy fabrics, loud sounds)… is present in 5–15% of the general population and is even more common (rates over 50%) in individuals with both genetic and environmentally-based psychiatric and neurodevelopmental disorders such as anxiety, attention deficit hyperactivity disorder, early life adversity, and autism spectrum disorder (ASD).”

The authors discuss altered thalamic sensory gating and an excitatory (glutamate) / inhibitory (GABA) neurochemical imbalance in ASD youth. Most of the research on sensory issues and GABA has been done in ASD children but it clearly applies to adults with anxiety too.

I highlight the motor issues with GABA/glutamate imbalances in the above GABA sensorimotor skills blog. This research is also looking at ASD populations but these mechanisms may account for her husband’s significant coordination problems/tripping.

You can read the current list of low GABA symptoms here. This list will be updated with sound and tactile hypersensitivity, and coordination problems/tripping (and a few others like asthma and laryngospasm).

An occupational therapist who is training as a nutritional therapist

Denise is an occupational therapist (OT) who is training as a nutritional therapist so she can recommend supplements for the kids she works with, alongside the other therapies she uses as an OT. I love this. I’m a big believer in using everything we have at our disposal and am a huge advocate of OT. I would love to see more OTs and other practitioners using the amino acids and nutritional therapy.

Denise shared that she actually started her journey in nutritional therapy 20 years ago due to the impact she was seeing in diet and autism. She took a very long break and had her own children and has now restarted her training. She shared this:

I plan to integrate nutritional advice into my work with families. As I am currently a NT student I haven’t been able to advise families even regarding the GABA Oolong tea [more on that below]. I am excited to qualify as I see various sensory, motor and attention issues that can be easily treated through nutritional adjustments and supplements.

Denise is already using the amino acids personally and with her family, sharing: “I love using aminos e.g. 5-HTP and L-theanine for myself and my daughters and GABA for my husband, tyrosine occasionally for my son.”

She has my book “The Antianxiety Food Solution”, a great resource that is practical and fully referenced, for both consumers and practitioners.

I encouraged her to also look into the amino acid training I offer for practitioners once she has completed her training as a nutritional therapist, so she can confidently use them with her clients too.

Having her in the program is also an opportunity for me and others in the group to learn from Denise about her expertise on integrating amino acids, nutrition and OT.

Her feedback on GABA oolong tea or GABA Calm for children with autism?

She also commented that she loved reading the GABA Oolong research – GABA Oolong tea in children with autism: improvements in sensorimotor skills, autism profiles, anxiety and sleep (new research)

I asked for her feedback and if she has kids in her practice, see any benefits when drinking this GABA Oolong tea. And what their responses are to the taste. Since she is still a student she can’t yet advise families regarding the GABA Oolong tea but she did say this:

To be honest I think the Source Naturals GABA Calm sublingual will be easier to tolerate for lots of children compared with tea.

As fascinating as the GABA Oolong tea research is, I feel the same way and I really appreciate this feedback from an OT. I have actually received similar feedback from a number of other practitioners too. Stay tuned as I continue to gather feedback.

Autism: diet, GABA and working with an OT

It’s amazing that 20 years ago Denise was seeing the impact of diet in kids with autism. If you would like to learn more, this blog – Nutritional and Dietary Intervention for Autism Spectrum Disorder – summarizes a 2018 study and offers many insights into to the progress since then.

As I mentioned above, her husband’s success with 3 GABA Calm illustrates the diversity of how GABA can help i.e. adults and children, males and females, and different dosing according to each person’s unique needs.

This is the blog Denise commented on – Half a crushed GABA Calm for my autistic child: sleep, anxiety and sensorimotor skills (writing, horse riding and swimming) improve.

In the above blog, I share Vic’s feedback about just half a GABA Calm improving her daughter’s sleep, social skills and sensorimotor skills such as pen and pencil use, horse riding and swimming. Her daughter is also working with an OT and getting those added benefits too.

Resources if you are new to using GABA and other amino acids as supplements

If you are new to using tryptophan, GABA or any of the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

Have you or a family member had GABA help with sound and tactile hypersensitivity, coordination problems and anxiety?

Which GABA product and how much?

And is the GABA product used sublingually or the capsule opened?

Are you an OT using amino acids and nutritional approaches with your clients, in addition to other approaches?

Do you find music therapy to be calming, in a similar way to the calming effects of GABA?

If you have other questions and feedback please share them here too.